Driving after a transient ischaemic attack (TIA) or minor stroke

The UK DVLA (Driver and Vehicle Licensing Agency) do not allow you to drive for at least a month after a stroke or TIA. After the first month, if the doctor agrees that you are fit to drive, you can do so. There is no need to notify DVLA unless you still have any remaining symptoms 1 month after the episode. If, after the month, the doctor or you feel that you are not fit enough to drive you have to tell the DVLA and your insurance company (see ‘Driving and transport’ on our stroke website or the DVLA website for more information).

However, the type of advice or guidance given to the people we talked to varied enormously and a few people were unsure about whether or not to notify DVLA, and when they could return to driving.

Most of the people we interviewed were told by their GP or consultant to stop driving immediately after their TIA and not to drive for between a month and six weeks. In a few cases the GP did not say anything about this and so people drove to their hospital appointment unaware they should not do this (see John below). For people like Angus (below) who relied on driving for work, having to stop could mean a loss of income (see ‘Work’).

Angus works as a fence erector for sports events. He is married with 3 adult children. Ethnic background/nationality' White British.

I mean, it was really silly, but the doctor actually from the hospital rung me on my mobile and said, “Come in, we need you in here now” and I said, “I can’t, because I’m just finishing off some work” and he wasn’t too pleased, sort of thing, and I went to see him the next day. And that’s when he said to me, “How did you get up here?” I said, “Well, I drove” and he said, “Well, you won’t be driving back” you know. Yes, and he stopped me from driving then.

It’s interesting he didn’t say that to you on the phone.

Yes, I did say this to him and he said he admitted he was a bit taken aback that I didn’t go and see him straight away when he said the first time, [laughs] you know, but I just didn’t associate the second. If he’d have said this after the first one I’d have gone straight away because I associated losing my speech with a mini stroke, with TIA, but no one says about, no one said about eyesight and different things, you know, and hearing, things like this. So I didn’t associate it with it and thought, “Oh, it’s just nothing,” even though the doctor had already told me, “Yes, it’s a second one”, I still weren’t, I weren’t convinced totally with the second one, you know.

Yeah, it hadn’t quite sunk in?

Not really, no. That’s what it was yes. But I soon, he soon convinced me otherwise [laughs].

And when you went up to the hospital and he said, “That’s it, you’re not driving home,” was that a shock?

Yes, yeah. Yeah, it was. I weren’t expecting that, because I actually felt normal again, you know. Like I say, they both only lasted, the first one for about 10 minutes and the second one about 20, maybe, 15 to 20 minutes. And I just felt normal afterwards, straight away. In fact I felt like a fraud, even, up the hospital, having all these tests done, because I felt normal, you know, but....

But what really got us was two or three things as to how it affected my work, in as much as I had to have, I weren’t allowed to drive for six weeks, which included - this was the beginning of December it started - so it included all of the Christmas period, which really upset our plans to do things. And also we had our 40th wedding anniversary on the, we was leaving this country on the 28th December to celebrate our wedding anniversary on the 3rd January in the Caribbean. And that had to be cancelled, because we were advised not to fly because of the condition. But this, it really affected my work more than anything in as much as I couldn’t drive, and I need to drive as I go all over the country doing my work as a fence erector, on working on Astroturf pitches, sports grounds etc.

The kick-on from all this is that I had all these few, quite a few, six weeks or so off work because of not being able to drive etc. - not necessarily because I didn’t feel right, because I did, you know. But I was told not to drive, so I had to, and that subsequently cost me more work because I wasn’t there to follow on, and so really I’ve not had a great deal. In the last four months I’ve probably only had about a month’s work, you know.

A few people were wrongly advised to notify the DVLA and surrender their licence, or did this on their own initiative. Dennis later regretted that he had handed in his licence.

Dennis is married with three children and five grandchildren. He is a retired music educationist and a practicing composer. Ethnic background' White English.

I was told not to drive, understandably, by my doctor. And in fact I made the mistake of putting my hands up to the DVLA, who immediately requested my license back. So I would recommend that yes, you stop driving, but you hold onto your license because it takes a very long time to get it back [laughs].

Have you managed to get it back now?

Oh, I have, yes, yes.

So you haven’t had to make any lifestyle changes, really, apart from the driving, which - how did you how did you manage to persuade the DVLA to give you back your license? Did you have to get a letter from the clinic or something or?

Yes, well, they give you forms to fill in, and I initially made the mistake of downloading forms from the, from the website, and mistakenly filled in the forms appropriate to heavy vehicle driving - an easy mistake to make, because it wasn’t terribly highlighted on the first page - and that involved getting a complete medical examination, at some expense, from your GP, which I did. So I provided them with far more information, accidentally, than they needed. Despite that I found them very difficult to deal with. I don’t think, I don’t think it was anything to do with suspicions about the medical situation. I think it’s just the way the DVLA work. In fact, they were highlighted on a Watchdog programme, I believe, on one occasion for inefficiency and incompetence. So I’m inclined to put it down to that. So I just had to keep badgering. In the end, I had to adopt a fairly strong tone with them and demanded to speak to a supervisor, and eventually was put through to one who said, “Oh, it so happens that your okay has come through today.” [Laughs].

[laughs] How fortuitous.

How fortunate. And that was it. But that was something like- oh, seven or eight months later. And the doctor in the team at Oxford who told me after a month that I was okay to resume driving.

So you had a long time. I mean that’s--.

I had a long time without my license. So, as I say, it’s better not to surrender the license until absolutely necessary, unless it’s absolutely necessary

However, the majority were not told that they needed to do anything official and kept hold of their licence, resuming driving when they felt fit enough to do so. For some, this was determined by re-visiting the GP and confirming that all was now well enough to start driving again, but others said they made the decision for themselves at a point at which they felt they were safe to drive again.

John is a documentary film-maker, married with one daughter. Ethnic background/nationality' White British.

I was aware that the next day I had an appointment with the GP at 9 am. Didn’t think it was serious enough not to drive, so was prepared to drive. Retrospect is pretty good, isn’t it? Whilst dressing that morning I had a strange visual disturbance on the left eye, the left periphery of that vision, a set of flashing chevron multi-coloured lights. Lasted a few, probably ten, fifteen seconds. Very strange. Got into the car, drove away from home. And we live on a very narrow lane and the lane happened to be blocked by a removal truck, so it required me to do a three-point turn through a gateway. And one side of the lane has a drop into a stream. And as I started to reverse I realised I had no understanding of where the car was in space, which was, really was very disturbing, because I drive a lot and I think I’m a relatively confident driver. Managed to reverse using the reversing indicators on the car, pulled out, stopped, and took a few minutes to get my brain back into a place where I could drive on. Drove to the GP, who within minutes said, “You’ve had a TIA.” I had never heard the acronym before. I didn’t know what it was. And she explained it was a mini stroke, that I was not to drive, I was to go immediately to the major hospital in the nearby city.

During the first consultation the consultant said, “You will not drive for a month.” And I questioned this. And I was told in no uncertain terms it would be very, very unwise to do so, and because I had been told by a medical professional, it would be illegal to do so. I asked what I should do about DVLA, and I seem to remember it was an optional, it was optional, as was also reporting to an insurance company. So the conversation went round to, “Okay. Let’s review this in a month’s time.” If no other incident has occurred, then the consultant was happy that I would be able to drive again. So I didn’t drive for a month. And on the thirty-first day after the incident I felt very confident about driving, and I have driven since.

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Profile Info

Age at interview:

78

Sex:

Male

Age at diagnosis:

74

Background:

Ken is married and has three adult children. He is a retired Air Force Officer. Ethnic background; White British.

Well after I, when I had the stroke, when I came out of hospital there was a period there was there when you know, went and saw the GP and he said, “Six weeks.” You know, “Don’t drive for six weeks and then come back.” So I did and he had a quick chat with me and says, “Well, I can’t see, you know…” took my blood pressure and that and he said, “Well I don’t see any reason why not.” You see, some, and this is purely for the insurance purposes.

What do you mean by that? Insurance purposes?

Well if you, if, if you, according to my belief is that if you’d had a minor stroke and hadn’t told the insurance and when gaily driving had an accident you wouldn’t be covered. It’s as simple as that.

So do you think it’s for your protection as a driver or protecting other people?

It’s both.

Yeah.

I think, I think it’s for your protection in so far as that you’re not insured and it’s for the protection of the public as well, to keep you off until you’ve, you make sure you’re recovered.

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Age at interview:

54

Sex:

Female

Age at diagnosis:

54

Background:

Yvonne is married and has an adult daughter and 2 young grandchildren. She is a police officer. Ethnic background' White British

Because I wasn’t diagnosed until six weeks after the stroke, apparently if you have a stroke then you hadn’t ought to drive for the four weeks and you should tell DVLA in that four weeks. But of course that has all ready gone past by the time I was diagnosed. My husband’s actually stopped me from driving because I, I did a couple of stupid things while I was behind the wheel. And he stopped me from driving.

But there’s nothing official that has said that you have, you can’t drive?

No, no.

I mean, how do you feel about that whole area because it‘s, it’s quite a sort of grey area isn’t it?

I think I’m … it’s quite scary. I mean, the fact that I had it whilst I was behind the wheel. And I felt quite out of control which obviously when you’re behind the wheel is not a good thing to be. So, you know, I think maybe you, you shouldn’t drive, until you feel within yourself actually confident that you would recognise the early signs. Stop immediately, etc etc.

But as you said it’s quite difficult to recognise, isn’t it?

Exactly. Yeah.

So, I mean, do you think it should be left how it is sort of up to the individual or do you think there should be some more…

Yeah, I think there should be something more…

..guidelines around that?

..definitive because four weeks is, you know, as I say I wasn’t diagnosed until after the four weeks was up. So kind of, should I have told DVLA?

I have not told DVLA? You know, it’s really quite difficult. And nobody, there’s nobody there to actually say, “Well, yeah, maybe should tell them.” You know, maybe we should have something like if you’ve had a stroke, you should tell DVLA within six months of you actually having that stroke. Or three months or whatever.

Because I guess going back to driving as well it’s a difficult decision to make whether or not you feel … I mean, you may feel you can or you know, just what the risks are.

Well I, I mean a couple of short journey so over the last couple of weeks and felt totally unconfident. I curbed the car, which is something I don’t do normally. And so I’ve said to my husband, “Maybe I’m not quite ready for it yet.”

Once it was made clear to people that driving was out of bounds for a period of time nearly everyone we spoke to adhered to the advice and stopped driving, although some people said that they actually felt well enough to drive before the month was up or felt tempted to take short trips to the shops.

David is married and lives with his wife Shirley. They have four adult children. He is a retired mini bus driver. Ethnic background; White British.

They told me that I was, I couldn’t …I mean they didn’t inform DVLA or anything but they told me not to drive for a month, which I didn’t do.

And so it was just left to you…

It was just left to me to police that. Yeah.

Right. And what do, what do you think about that whole idea about leaving people to just make their own decision about that? I mean, did you feel able to kind of decide when you were ready to go back to driving or?

Oh yes. I think I would prefer it that way, unless they thought that there was a chance of me, you know, of ignoring it because I’m quite a strong character when I want to be. And anyway I had the backup again of my wife, who is my carer and if I’d had decided before the month was up that I wanted to drive, she would have either of hidden or thrown the keys miles or something so I wouldn’t be able to drive anyway.

Right.

And they, they knew that. They could see that Shirley was quite cap, was quite capable of you know, policing that as it were.

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Age at interview:

61

Sex:

Male

Age at diagnosis:

60

Background:

Angus works as a fence erector for sports events. He is married with 3 adult children. Ethnic background/nationality' White British.

I didn’t know what to think, because it was the stopping me driving which really hit home that there was a problem, when they said that a lot of people, quite a high percentage of people who had TIAs go on to have a stroke, a debilitating stroke, within the next month, you know, and it was that I was more concerned with and not - getting over that month was great, after Christmas had come and gone it was like a month had gone and it was, “Yeah, I’m sort of, I’m okay”, sort of thing, you know. That was the only time I really worried about it, because that was the time - and once I’d got my, once I was allowed to drive again, you know, I felt then, yes, I’m back to normal. Even though I’d felt normal all the time, in myself it was, “Yes, this is great”, yeah.

Being unable to drive was a difficult experience for some people. Some said that they felt they felt they had lost their independence because they could now no longer go out in the car without thinking and it made them realise how much we take driving for granted. It could also be difficult to have to rely on friends and family for lifts to do the usual everyday things that they needed to do, especially those who lived in rural areas. Some people said they found it difficult to have to rely on public transport because it was less convenient.

George is married with one adult daughter. Ethnic background; White British.

What was the worst bit, thing about that?

About driving? Well, I’ve been driving, what -, 59 years? Well at the time of my TIA, 53 years and then all of a sudden you, you’re not allowed to drive anymore. And when she gave me the OK to drive I, she said, “Don’t go on the motorways, don’t go on the [dual carriageway], not for a few more weeks. And notify the DVLA.” Which I did. They were quite happy for me to carry on driving, no problems at all. So I’ve got a letter from them to, to confirm that so I feel quite happy about that.

And do you feel confident driving now?

Oh, absolutely, yes. Yes, no problems at all. I mean, just by just taking one aspirin I feel as confident, as happy as a, as a sandboy really. You know, for health-wise.

So at the time when you couldn’t do the driving, did it, was it partly the sort of, that loss of independence that you’d been so used to having, being able to just get …

Well, yes, I mean, just imagine it, all of a sudden you’re not allowed to drive.

You’re more dependent on other people to take you …

Absolutely, I mean, I had the hospital car service backwards and forwards to the hospital and the wife had to drive me if I went anywhere and So yes, it was awful really. I just can’t explain to you how bad it was.

I know it may sound a bit silly, because of having these strokes, rather than going on driving holiday, we’ve used coach holidays since and I think to myself, “Well, say that driver was to have one now, you, he may not get a warning.” And he’s belting up the motorway and you think, “So, there’s absolutely no warning whatsoever,” then you think about these people driving down the motorways at terrific speeds, it could happen.

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Age at interview:

68

Sex:

Male

Age at diagnosis:

65

Background:

Geoff is married and has three adult children. He is a retired bank employee. Ethnic Background; White British.

Geoff' It’s made a great impact. I mean, we’re fortunate in having our bus passes. I mean, we’ve got our over, over-60s railcards and bus passes. I mean, our daughter lives down in, in Cornwall and we used to drive down there to see them. And after I had my stroke my daughter came up didn’t she?

Enid' mhm.

Geoff'And spent a few days with us.

So now, if you want to go and visit you have to do it a different way, you have to take train or something like that?

Geoff'We go on the train.

Yeah.

Geoff' And so …

Enid' And she meets us at the station, doesn’t she?

Geoff' Yeah. But she lives out in the country down in Cornwall so you really need a car. I mean, my, we, are fine going down on the train, I mean, it’s better that, it’s better than actually driving but it’s when you get down into Cornwall and she lives out in the country and we can’t drive.

What are the limitations for you about, I mean, just getting your shopping and all those kind of things? Well how does it, how does it pan out for you?

Enid' Well our son takes me on a Thursday morning shopping, which I’ve been this morning. And if he can’t go for any reason I go down and do the shopping and have taxi back.

Geoff' Or sometimes you have a walk down, don’t you?

So you’ve found ways, you find ways around it but at the same time it, it sounds like it upsets youto not be able to have that, is it …

Geoff' Yeah.

… about losing your, your independence?

Enid' It’s independence, isn’t it really.

Geoff' I mean, when you’ve got a car there you, you can think, “Oh I’ll just nip, nip down to the shops.” But going out for shopping now, you, when we go back to the hospital I mean, I went to the hospital…

Enid' Tuesday.

Geoff' I went to the hospital on Tuesday because I’m now on warfarin after a, all me procedures [laughs] so about every six weeks I’ve to go and have my warfarin level checked. And which, we’ve to make a, a day of it almost haven’t we to get back to the hospital.

So things take a lot longer…

Enid' A lot longer…

... for you?

Geoff' A lot longer, yeah.

Enid' Yeah.

Geoff' It’s all right saying you, you, “Well you’ve got a bus pass, you can go anywhere on it,” but it’s the time it takes.

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Profile Info

Age at interview:

67

Sex:

Male

Age at diagnosis:

67

Background:

David is married and lives with his wife Shirley. They have four adult children. He is a retired mini bus driver. Ethnic background; White British.

Did the fact that you weren’t able to drive for a while did that cause any, any issues or problems for you?

It caused issues as far as going into town and shopping and that because we do have quite a reasonable service, bus service out here. But as you can see where we are it’s, you know, without a car, it’s not that easy for certain things like big items of shopping, potatoes, milk and things like that. Or taking rubbish to the skip which we do quite, well used to do quite a bit of. Yeah, that is where the car comes in so useful.

So then after the month you resumed, you felt OK and resumed driving?

Yes I have driven since.

And then …

Although I don’t drive anywhere near as much as I used to now.

And is that related to what happened or is that just because you slowed down a bit or?

I’ve slowed down a bit and I don’t feel so confident anymore. Yeah, I just don’t feel…

That’s fine. Yeah.

..so confident anymore.

Yeah.

This is one of the biggest things that this stroke has done.

Several people had been actually driving when they had their TIA, but because of the difficulties in recognising symptoms or realising what was happening (see ‘Symptoms’ and ‘Delay in seeking help’) they had carried on driving.

Yvonne is married and has an adult daughter and 2 young grandchildren. She is a police officer. Ethnic background' White British

I was driving to work, and I noticed that my vision had gone funny. It was getting very fuzzy around the edges. But I have suffered from migraines in the past so I just thought maybe that was what was starting. Then my left leg went numb. My left arm went numb. Fortunately I was driving an automatic so it didn’t really matter, I didn’t have any gears to change or anything. I was starting to get a bit worried by that stage and then I felt as if my mouth had dropped. I managed to get into the police station car park. Sort of abandoned the car really, it wasn’t really parked. Kind of fell out of it thinking, “What the hell’s wrong with me?”

You said you were driving when you first felt something going on, and you, and you did say fortunately it was an automatic car. I mean, what would think might have been the case, you know, what do you think might have happened if it hadn’t been an automatic?

I did …

Do you think you would have been able to carry on driving?

I, no I wouldn’t ….

Have an accident or something?

… have been able to carry on. No, I would have had to stop the car somehow. Which would have been very difficult because obviously my left leg I couldn’t lift it so I wouldn’t have been able to, you know, put it on any of the pedals. And also my left arm, I couldn’t lift, so I wouldn’t have been able to pull on the handbrake or anything. And also it’s, it was very heavy traffic. You know, we’re talking about half past seven in the morning going into [local town] so …

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Age at interview:

79

Sex:

Female

Age at diagnosis:

72

Background:

Anne is a retired assistant college secretary. She is widowed and has 3 grown-up children. Ethnic background' White British.

I was driving to meet a friend, and I suddenly felt very peculiar and I said to myself “Do I stop? Do I go home? Do I go on? What?” and decided just to go on very slowly, and sure enough in a mile or two it was all over and done with, but I felt the most extraordinary sensation, “If this is dying, it’s not really all that bad.”

It was very odd, the sort of the machinations of the mind, thinking, you know, what to do and then deciding, “Well, you know, I mean it’s a little hiccup but let’s go on”, and in fact it worked out all right, but it was lucky that it did. So it shows what sort of period of time it lasted.

One person that we interviewed has had to stop driving permanently because of residual effects on his eyesight. Geoff was told that unless his vision improved he would no longer be allowed to drive which he found very upsetting.

Geoff is married and has three adult children. He is a retired bank employee. Ethnic Background; White British.

About my vision? Well I, I was going up to the optician and up at the hospital and they were , they were doing the visual field test and realised that I had this problem and said it probably won’t get any better. But now normal, you know, normal living I don’t seem to have any problem with my eyesight. And this is why it gets me so upset really.

And so at that, at what point did you surrender your driving licence? And did somebody tell you, you had to do that? What happened? How did it come about?

Well, obviously I couldn’t drive after I’d had the stroke and I was asking the doctor when I could drive and he said, “Well it’s all, it all depends on your, on your eyesight.” He said, “So, they’ll be, you know, they’ll be doing the, the eyesight tests and you’ll have to wait for the results of those.”

So I didn’t drive again. I mean, we have the car in the garage and I was driving it in and out of the garage to, to keep it mobile and that was fine. I mean, I, I always reversed into the garage so I was driving it out, warm, keeping the engine warm, then reversing it back in. And I mean, there was only, there’s only inches on one side and a foot on the other and I could do that but, but that annoyed me more than anything. I was driving the car [laughs] in and out the garage yet I couldn’t go on the road with it.

Another person who still experiences some residual symptoms after experiencing two TIAs says that although he is still allowed to drive at the moment, he can foresee a time when he may have to give it up.

Russell is married and has two adult children. He is a retired insurance underwriter. Ethnic Background; White British.

Diana' He was told he could have another within two weeks. Which was why he was told not to drive the car.

And obviously you didn’t drive the car?

Diana' No.

How did that, you know, impact, because you said you’d been unwell and then you’d had to sort of stop driving and lost that bit of independence presumably, how did that feel between those two episodes?

Russell' I don’t think that it was serious because I’d hyped myself up to it. I mean, it, it’s quite I quite expect that I shall be stopped driving permanently sometime in the future. I’m quite, it, it’s all right now I’m, I’m relatively fit and, and, and I’m alert and I can drive. But it, it would not be you, you, you build yourself up. It, it’s going to happen. I’m not going to drive, eventually I shall be stopped.